HomeMy WebLinkAbout7126 Crooked Arrow Ln - Applications/Single Family New - 03/07/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
F6rt Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970.221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 172 1 ice/ 1 t92,CO APPLICATION DATE S- /- 13
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 9_20S. 412. i35 Z.
Last name First Name —IZ1g.`f — Middle
r, Street Address o. so\. 35cgal City W&WffYU l%4.ST*R_ State_CoL? Zip 9 CO'3
CONTRACTOR INFO: Company Name SAftA cw cve"4= 15;C, Contractor Phone #
Lic Holder Name
City of Fort Collins License #ht0C7S Supervisor Cert #
Mailing Address Pa. jBioD* 35bQDq City w(��j'rilr:C_qtAZ-State CAD Zip scy'J5
LEGAL INFO:
Subdivision/PUD P caa o )►.ice Filing # 3 Lot # 5 Block # 5 Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) (g ��- Total Garage Sq Ft 522-
Residential Sq Ft l S 12 Comm'I Sq Ftt4l A # of Stories Bldg Height 241 — 1
111 # Dwelling Units µ1 A
15' Floor Sq Ft 2°d Floor Sq Ft r4 IA 31 Floor Sq Ft N A Unfiished Bsmt Sq Ft IV2,0
Finished Bsmt Sq Ft 1000 1 # of Bedrooms 4 # of Full Baths S2. 3/< Baths _*j '/z Baths 4-6— # of Fireplaces
lw1 - 1%^T M 8S&X
Air Conditioning: es No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
ResCheck w/Blower Door 0§imulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: P(Gas ❑ Electric Electric Main Breaker Size (Residential only) >(150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 22q.-72-1 •�/
Description of Work: H4E�1,2 S1A6Lg..� IlLuL.N
640'r 5 RAA1
Contact Name & Phone # of JOBSITE SUPERVISOR: rn1jLN� STelv41fY1e�120• 030i. 1333
Subcontractor Info:
Solar µ' 14 Other _ Other Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances
and
'state laws regulating building construction. 2� �f 1
Applicant Signature /+�,, _�'f—�• G✓5t Print Name )67r b4 Phone OS- 40q, I385
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATIIOM EXPIRES 180 DAYS FROM APPLICATOON DATE